Contemporary Clinical Dentistry

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 9  |  Issue : 6  |  Page : 197--203

A comparison of oral midazolam-ketamine, dexmedetomidine-fentanyl, and dexmedetomidine-ketamine combinations as sedative agents in pediatric dentistry: A triple-blinded randomized controlled trial


Astha Jaikaria1, Seema Thakur1, Parul Singhal1, Deepak Chauhan1, Cheranjeevi Jayam1, Kartik Syal2 
1 Department of Pedodontics and Preventive Dentistry, HP Government Dental College and Hospital, Shimla, Himachal Pradesh, India
2 Department of Anesthesiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Correspondence Address:
Dr. Astha Jaikaria
Room Number 310, Third Floor, Department of Pedodontics and Preventive Dentistry, HP Government Dental College and Hospital, Shimla - 171 001, Himachal Pradesh
India

Introduction: It is common to encounter a patient who is anxious to the magnitude that precludes the possibility of provision of dental treatment. This study aims to evaluate and compare the sedative effect of oral combinations of midazolam-ketamine (MK), dexmedetomidine-fentanyl (DF), and dexmedetomidine-ketamine (DK) in a group of uncooperative children requiring dental treatment. Methodology: This was a prospective, randomized, triple-blind study where 36 children who were 3–9 year old with American Society of Anesthesiologists –I status and presenting early childhood caries were randomly assigned to: Group A – 0.3 mg/kg of M and 5 mg/kg K, Group B – 2 ug/kg of D with 3 ug/kg of F, and Group C – 2ug/kg of D with 5 mg/kg of K in 1 mL honey. Patients' blood pressure, heart rate, and oxygen saturation were recorded from the start of the procedure till discharge. Patients' behavior, sedation status, and wake-up behavior were evaluated with Modified Observer Assessment of Alertness and Sedation Scale and ease of treatment completion by Houpt scale. Results: Hemodynamic changes were statistically insignificant in all three groups. 72.8% of patients in Group A and 58.3% of patients in Group B were successfully sedated during treatment. Behavior improvement was seen in all three groups during treatment with statistically insignificant difference in behavior scores produced by Group C. Ease of treatment completion was moderately better with Group A. Conclusion: Oral DK has a comparable sedative property with oral MK combination. Oral DF promises to be a potential sedative agent for children due to its successful anxiolysis.


How to cite this article:
Jaikaria A, Thakur S, Singhal P, Chauhan D, Jayam C, Syal K. A comparison of oral midazolam-ketamine, dexmedetomidine-fentanyl, and dexmedetomidine-ketamine combinations as sedative agents in pediatric dentistry: A triple-blinded randomized controlled trial.Contemp Clin Dent 2018;9:197-203


How to cite this URL:
Jaikaria A, Thakur S, Singhal P, Chauhan D, Jayam C, Syal K. A comparison of oral midazolam-ketamine, dexmedetomidine-fentanyl, and dexmedetomidine-ketamine combinations as sedative agents in pediatric dentistry: A triple-blinded randomized controlled trial. Contemp Clin Dent [serial online] 2018 [cited 2019 Jul 18 ];9:197-203
Available from: http://www.contempclindent.org/article.asp?issn=0976-237X;year=2018;volume=9;issue=6;spage=197;epage=203;aulast=Jaikaria;type=0